Provider Demographics
NPI:1700958147
Name:KLEIN, JASON H (PT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:H
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 E 74TH ST
Mailing Address - Street 2:STE 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3235
Mailing Address - Country:US
Mailing Address - Phone:917-774-4600
Mailing Address - Fax:
Practice Address - Street 1:159 E 74TH ST
Practice Address - Street 2:STE 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3235
Practice Address - Country:US
Practice Address - Phone:212-838-8023
Practice Address - Fax:212-838-8027
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQL0371Medicare ID - Type Unspecified